Initial assessment of total hip replacement surgery at 7A Military Hospital. Subjects and research methods: A cross-sectional descriptive study, conducted from 3/2014 - 4/2018 on 47 patients with a total of 52 total hip joints (THJ) were replaced at 7A Military Hospital. Result: The average time of surgery was 91.92 ± 15,847 minutes. The average length of treatment: 15.5 ± 4,948 days. Evaluation by HARRIS score: Very good + good: 96.2%, Average + poor 3.8%. Complications: Superficial Infections on incision 1.9%, dislocated joints 1.9%, loose stem 1.9%, no serious complications. Conclusion: Total hip joint replacement to treat osteoarthritis, aseptic necrosis of femoral head, femoral neck fracture is an effective treatment, restoring the patients' joint movement function, and with low complication rate.

Aim of the study: The aim was to determine the blood concentrations of hydroxychloroquine in Moroccan systemic lupus erythematosus patients and identify the factors associated with interindividual variation. Methods: A cross-sectional study enrolled patients with lupus erythematosus. We recorded demographic features of patients and main clinical and biological characteristics of the disease. We determined the blood concentrations of hydroxychloroquine for the entire patient enrolled in this study by liquid chromatography – mass spectrometry. Patients were divided according to their blood hydroxychloroquine level into three groups: low blood concentration (<500 ng/mL), therapeutic range (500-2000 ng/mL) and high blood HCQ concentration (>2000). Results: Eighty subjects were included; 77 were female and the mean age was 36.9±12, 2 years. The median concentration of hydroxychloroquine was 830 ng/mL (range: 35-3,200 ng/mL); 13 patients (16%) had low blood levels, 59 (74%) were in therapeutic range while 8 (10%) had high blood concentrations. Low body mass index and the use of corticosteroids were associated with high hydroxychloroquine concentrations (p=0.03 and p=0.02 respectively). Conclusion: We report for the first time the blood concentration of hydroxychloroquine in Moroccan lupus patients and we found significant variability between patients for the same dose. Various factors affected this concentration and further studies are needed to expand the sample.

Management of patients in emergency departments is an important indicator of the quality of a healthcare system. In selected patients with acute appendicitis can we treat them by antibiotic therapy alone? The study aimed to assess the long-term efficacy of non-operative treatment in the management of uncomplicated acute appendicitis. A Prospective Cohort study was carried out in a periphery hospital, it included adult female patients satisfied the research criteria (January 2017 to December 2018). Those were including the clinical signs and symptoms of acute appendicitis, and radiological findings suggestive for acute appendicitis. Nonsurgically treated patients were divided in two groups based on the treatment outcome either successful or unsuccessful. It included 52 patients their mean age was 25.2±9.7 years. The majority were from the age group > 20 -30 years (46.2%). All had right iliac fossa pain, tenderness and rebound tenderness. Only in 43 (82.7%) patients the ultrasound was diagnostic. All patients received combined antibiotics in the form of intravenous 3rd generation Cephalosporin 1 gm twice a day and Metronidazole 500 mg three times a day. Successful cases were discharged on oral antibiotics for further 7 days. Successful, failure and recurrence rate were 93.8%, 7.69% and 6.3% respectively. Satisfaction questionnaire was filled by patients who treated conservatively and it revealed that 96.2% were satisfied from such type of management. In conclusion, the use of antibiotics for suspected acute non complicated appendicitis is effective and may avoid unnecessary appendectomy. Once nonsurgical management is started, close monitoring of patient's clinical condition is mandatory.

Background: The number of kidney, liver, heart and other organ transplants is growing rapidly, but not nearly as rapidly as the growth in the number of persons with defective organs who desire transplants. Also, cadavers are needed for Anatomy dissection classes for medical students. Methods: The study assessed the knowledge and awareness levels of 134 first professional MBBS students, who filled a prevalidated questionnaire. Observations and Results: Out of 134 students, 87.3% of the respondents were aware of the concept of organ donation while 12.7% had not even heard about it. 83.7%, 78.6%, 36.8% and 20.5% were aware about eye, kidney, whole body and liver donations respectively. Awareness of donation of other organs was found to be in the range between 11.9% and 7.7%. 48.7%, 29.1%, 14.2%, 9.4% and 1% of the aware respondents started that television, internet, newspaper, family members and other sources respectively were their sources of information regarding organ donation. Conclusions: Educating the public, supportive care, proper infrastructure, addressing various issues of organ and body donation - all these can help in improving the peoples’ understanding, and therefore increased rate of donation.

Background: Ankylosing spondylitis (AS) belongs to a group of related disorders called spondyloarthropathies. It is the most common and most typical form of spondyloarthropathy. Men are usually affected three times more than women. The disease is characterized with inflammatory back pain starting in adolescence and early adulthood. When patients are diagnosed after the age of 45 years, it is possibly because symptoms over the years have been minimal. Methods: This was a prospective study of patients that were seen in the rheumatology out-patients department of a specialist hospital over a period of one year. A detailed history of back pain, heel pain, enthesopathy and peripheral arthritis were obtained. Histories of conjunctivitis, urethritis, inflammatory bowel disease and family history of ankylosing spondylitis were obtained. Inclusion criteria were patients that were previously diagnosed as AS and those who met the modified New York criteria for classification of AS. A thorough examination of spinal and extra-spinal regions was carried out. Investigations carried out included rheumatoid factor, tissue typing, plain radiograph and magnetic resonance image of the sacroiliac joints. Results: There were 840 patients that presented in the rheumatology clinic over the study period. Thirty two patients presented with various spondyloarthropathies while 12 of them were diagnosed as ankylosing spondylitis. Male to female ratio was 11: 1. The age range of the patients was 18 - 54 years with a mean of 46 ± 4 years. The duration of symptoms varied between 9 months to 28 years. Frequencies of initial presentation were low back pain in five, peripheral arthritis in four, heel pain in two and uveitis in one patient. Extra–articular presentations included aortic incompetence, pulmonary fibrosis and non-specific abdominal pain. All the patients had sacroiliitis. Joint involvement was asymmetrical and joints of the lower limbs were majorly affected. Test for rheumatoid factor was

Hepatitis B is an infectious disease of great public health importance. Nigeria is one of the countries with the highest incidence of Hepatitis B Virus (HBV) infection worldwide. However, the accessibility and affordability of HBV DNA quantification (viral load) assay which is the key laboratory test for therapy initiation, and monitoring is a challenge to HBV management. The study was done to evaluate serum levels of HBV-DNA concentration and HBsAg titers of hepatitis b virus-infected subjects at NAUTH Nnewi. Cross sectional study design was used with a total of 264 subjects comprising of 88 HBsAg seropositive treatment naïve subjects, 88 HBsAg seropositive subjects on antiviral therapy as case subjects and 88 age-matched apparently healthy HBsAg seronegative individuals were recruited as control subjects. Hepatitis BVirus DNA assay was performed using real time PCR technique, ELISA technique was used for Hepatitis B surface antigen quantification, Hepatitis Bcore Antibody Immunoglobulin M and Hepatitis D Virus Immunoglobulin G assay. Immunochromatography was used for HBV Panel, Hepatitis C Virus assay, Human Immunodeficiency Virus testing. HBsAg quantification showed strong positive correlation with HBV DNA viral load both in treatment and non-treatment groups (r = 0.673; p < 0.001). The non-treatment group has higher viral load (M=805.50IU/ml) compared with treatment group (M = 65.50IU/ml) (p<0.001).

Background: To assess the significance of umbilical cord blood alkaline phosphatase and umbilical cord blood bilirubin as a combined marker for prediction of neonatal hyperbilirubinemia. Methods: The present study was conducted in department of Pediatrics, Mata Chanan Devi Hospital, Janakpuri, New Delhi between march 2018 to september 2019 included 370 healthy full term newborns fulfilling inclusion and exclusion criteria. The cord blood alkaline phosphatase level and cord blood bilirubin level were measured at birth. All the neonates were clinically observed for the development of jaundice for 5 days and serum bilirubin level estimation was done as and when required. Significant hyperbilirubinemia was considered when serum bilirubin level in term newborns was more than or equal to 12 mg/dl at 24 hrs of life, 15 mg/dl at 48 hrs, and 17 mg/dl at 72 hrs. Results: Out of 370 cases, 58 neonates developed significant hyperbilirubinemia i:e 16%. 28 babies had ABO incompatibility out of which 11 had significant hyperbilirubinemia (p=0.002) and 23 babies had RH incompatibility out of which 11 developed significant hyperbilirubineia (p <0.001). Mean ± SD cord blood bilirubin level in no significant hyperbilirubinemia group and significant hyperbilirubinemia group was 1.63±0.44 mg/dl and 2.49±0.22 mg/dl respectively with statistical analysis (p <0.001). There is no significant difference of cut off value of cord ALP level at 140.5 IU/L between significant and non significant hyperbilirubinemia group (p=0.398). Among Neonates with significant hyperbilirubinemia 55.18% were having cord blood bilirubin level >2.205mg/dl and cord blood ALP level >140.5 IU/L, in remaining 44.82% the cord blood bilirubin level was ≤2.205 mg/dl and cord blood ALP level was ≤140.5 IU/L and combined statistical analysis showed significant neonatal hyperbilirubinemia (p<0.001). Conclusions: Our study showed no significant association between cord blood ALP level and neonatal hyperbilirubinemia. Optimum

Oral and Maxillofacial region encompasses a wide spectrum of diseases, injuries and defects involving the head, neck, face, jaws and the hard and soft tissues of the oral cavity. Soft tissue injuries, when they occur in isolation or in combination with other injuries, are among the most challenging tasks to manage by the operator. In spite of their high incidence, there are very few studies noted in the literature which systematically elaborates the management of these injuries. This articles aims at emphasizing on the various dressings that can be used in the management of soft tissue injuries of the Oral and Maxillofacial region.

The play "This place does not exist" has been recently released in Peru, it is promoted as a social protest against illegal mining and prostitution of teenagers in the peruvian jungle, however, a scientific analysis reveals that it has actually been carefully designed with a goal : the promotion of brain internet in the jungle. The play belongs to the millionaire media campaign to promote the cerebral internet and digital fascism. The transmission of thoughts from the cerebral Internet via wi-fi is recreated in its advertising that shows an adolescent with an open brain and an recreation of transmission of thoughts, the transmission of private life with cerebral Internet is promoted subliminally under the argument of visibility as the main way of getting out of poverty. Although this play is promoted as a social protest against slavery of teenagers of the jungle actually it promotes sexual slavery with surveillance and mind control of these teenagers with brain net.

A case of sustained transfusion independence in a patient affected by chronic bone marrow failure by gelatinous transformation under long term self-administration of moringa oleifera is reported.

Introduction: Sarcoma is a rare entity with the primary pancreatic sarcoma represents a diagnostic challenge. Material and Methods: I reviewed articles particularly radiology studies in English language found in PubMed that were published recently to draw conclusions. Results: The common presenting symptom is vague abdominal pain. The described imaging appearance of such entity which shared between the different subtypes is a large heterogenous solid mass with frequent cystic degeneration/necrosis. The regional lymph nodes are rarely involved. Overall, poor prognosis of primary pancreatic sarcoma was reported. Conclusions: Although primary pancreatic sarcoma diagnosis remains a challenge, imaging differentiation from pancreatic ductal adenocarcinoma may be possible.

The platelet transfusion must necessarily meet the concepts of safety and transfusion threshold. Asking for an indication and prescribing a platelet transfusion remains complex and must take into account an increasing number of parameters (indication, quantitative and qualitative choice of product, the notion of the threshold, clinical situation and finally the cost).The study that we conducted is a retrospective descriptive and analytical study, over a period of 2 years, from January 2017 to December 2018, with the objective of studying the stages of preparation of platelet concentrates, their indications, their complications, and to report on the experience of platelet transfusion within the Avicenne Military Hospital in Marrakech. During this period, 777 platelet concentrates (753 SPC and 24 APC) were delivered to 107 patients. The department of internal medicine where a hematology-oncology unit is located is the most demanding department. The average of transfused bags is 7.5 bags/patient. The indication was curative in 55%, dominated by thrombocytopenia of central origin. The pre-transfusion platelet count was 54 10³ / mm³ for standard platelet concentrates (SPC) and 27 10³ / mm³ for apheresis platelet concentrates (APC). Finally, the platelet transfusion yield was greater than 20% in 50% of the cases. These data make it possible to demonstrate compliance with the indications for platelet transfusion in the most demanding departments, but raise the question of the dose that must be respected in order to improve platelet yield.

The antifertility potency of Marijuana had been revealed in our recent study. Hence, investigating its effect on other body systems became necessary. This study was setup to determine the effects of inhaled marijuana and Vitamin C on serum lipids and serum proteins of male rats using the following parameters; Total Cholesterol level, Triglycerides level, High density Lipoprotein level, Low density Lipoprotein level, Albumin level, Total Bilirubin level, Direct Bilirubin level and Total Protein level. This study was carried out with a total of forty (40) male wistar rats randomly divided into four groups of ten (10) rats per group. Group 1 was the control and was treated with distilled water, group 2 was the low dose group (exposed to marijuana smoke for 5 minutes daily), group 3 was the high dose group (exposed to marijuana smoke for 10 minutes daily) and group 4 was the high dose + vitamin C group (exposed to marijuana smoke for 10 minutes and orally gavaged with vitamin C at 2.8 mg/kg body weight daily). The animals were sacrificed on the 29th day and blood was collected by cardiac puncture into plain bottles. The collected blood was allowed to clot and centrifuged at 300rev per minutes for 20mins. The serum was collected with the aid of a micropipette for the biochemical analysis of lipid profile and serum protein according to George, 2009 and Bjorsten et al., 2007. The results were as follows; Serum albumin and Total bilirubin levels were significantly decreasing (p<0.05) down the groups. Direct bilirubin level was significantly increased (p<0.05) in the low dose marijuana (LMJ) treated group when compared with the control group and was significantly decreased in the high dose marijuana + vitamin C (HMJ+Vit C) treated groups when compared with control and high dose marijuana (HMJ) treated groups respectively. Total protein was significantly decreased (p<0.05) in the high dose Marijuana + vitamin C (HMJ+Vit C) treated groups when compared with control group and within the other groups. Total cholesterol levels was significantly decreased (p<0.05) in the high dose Marijuana + vitamin C (HMJ+Vit C) treated groups when compared with control group. High density lipoprotein levels was significantly decreased (p<0.05) in the high dose Marijuana + vitamin C (HMJ+Vit C) treated groups when compared with control group. Triglycerides level was not significantly different in the low dose Marijuana (LMJ) treated group and high dose Marijuana + vitamin C (HMJ+Vit C) treated groups when compared with control group and within the groups. Low density lipoprotein level was significantly increased (p<0.05) in the high Marijuana + vitamin C (HMJ+Vit C) treated groups when compared with control group. This study has shown that inhaled Marijuana negatively affected various liver metabolic pathways leading to decline in albumin levels; elevated Bilirubin and lipid levels.Co-administration of oral Vitamin C was found to lower serum Bilirubin levels. Levels of total Cholesterol, High Density Lipoproteins and Tryglycerides were also lowered in rats treated with Vitamin C. It is possible that the use of Vitamin C may be beneficial in individuals at risk of cardiovascular diseases.